Provider Demographics
NPI:1790041408
Name:LINDVALL, HANS CHARLES NELS (PA)
Entity type:Individual
Prefix:
First Name:HANS
Middle Name:CHARLES NELS
Last Name:LINDVALL
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:281 STATE HIGHWAY 20 E
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-3929
Practice Address - Country:US
Practice Address - Phone:850-835-1235
Practice Address - Fax:850-835-4195
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2024-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9118852363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant